A Prospective Comparative Study of Two Indirect Methods for Confirming the Localization of an Epidural Catheter for Postoperative Analgesia
| Autor: | Jean-Pierre Tétrault, Remi Robichaud, René Martin, Lucie Laroche, Étienne de Médicis |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Adult
Epidural Space Male medicine.medical_treatment Catheterization law.invention Randomized controlled trial law medicine Humans Prospective Studies Prospective cohort study Saline Loss of resistance Aged Aged 80 and over Pain Postoperative business.industry Middle Aged Electric Stimulation Epidural space Analgesia Epidural Epidural catheter Catheter Anesthesiology and Pain Medicine medicine.anatomical_structure Dermatome Anesthesia Female business |
| Zdroj: | Anesthesia & Analgesia. :1830-1833 |
| ISSN: | 0003-2999 |
| DOI: | 10.1213/01.ane.0000184130.73634.be |
| Popis: | We prospectively evaluated, in randomized order, 2 indirect methods of confirming the localization of an epidural catheter for postoperative analgesia in 218 surgical patients: epidural stimulation test (EST) and epidural pressure waveform analysis (EPWA). The epidural space was localized by using a loss of resistance technique. All catheters were inserted 5 cm into the epidural space and primed with 5 mL of 0.9% normal saline. There were no differences between the methods: the positive predictive value and specificity were high (100% in both groups), but the sensitivity was moderate (80% for EST and 81% for EPWA) and the negative predictive value was low (16% for EST and 17% for EPWA). Combining both methods yielded better sensitivity (97%) and negative predictive value (57%) (P < 0.001). The sensitivity of EST was increased to 87% (P < 0.05) if sensory response was included as well as motor response for stimulation less than 10 mA. We suggest the inclusion of sensory response in the appropriate dermatome at a current |
| Databáze: | OpenAIRE |
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